Abdominoperineal resection for rectal cancer: Historic perspective and current issues Journal Article


Authors: Chessin, D. B.; Guillem, J. G.
Article Title: Abdominoperineal resection for rectal cancer: Historic perspective and current issues
Abstract: The technique of APR has changed substantially in the past century, with significant improvements in early postoperative outcome, long-term oncologic outcome, and quality of life. APR, according to the principles of TME, has provided for substantial improvement in local failure and overall survival rates. In addition, when oncologically appropriate, APR performed with ANP can contribute to substantial improvements in postoperative genitourinary and sexual function. Experience with laparoscopic-assisted APR suggests that this procedure may provide for decreased postoperative morbidity, and appears safe and effective for rectal cancer resection. However, large, prospective studies are needed before definitive conclusions can be drawn. The future challenges in the management of a patient with rectal cancer felt to require an APR include the determination of the optimal use of chemoradiation and immunologic therapy, better definition of the role of laparoscopy, better understanding of the pathophysiology of bladder and sexual dysfunction, and further improvement in local and distant control of disease. It is important to recognize that a century after its introduction, APR remains a valuable procedure in the curative treatment of select patients with distal rectal tumors. © 2005 Elsevier Inc. All rights reserved.
Keywords: cancer chemotherapy; treatment outcome; cancer surgery; surgical technique; clinical trial; mortality; review; fluorouracil; cancer radiotherapy; pelvis; laparoscopic surgery; treatment indication; adenocarcinoma; quality of life; morbidity; history, 20th century; statistical significance; history, 19th century; urologic surgical procedures; urogenital system; rectal neoplasms; rectum cancer; sexual function; rectum abdominoperineal resection; history, 18th century; portraits; autonomic nervous system function
Journal Title: Surgical Oncology Clinics of North America
Volume: 14
Issue: 3 SPEC. ISS.
ISSN: 1055-3207
Publisher: Elsevier Inc.  
Date Published: 2005-07-01
Start Page: 569
End Page: 586
Language: English
DOI: 10.1016/j.soc.2005.04.002
PUBMED: 15978430
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 12" - "Export Date: 24 October 2012" - "CODEN: SOCAF" - "Source: Scopus"
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. David Brian Chessin
    23 Chessin
  2. Jose Guillem
    414 Guillem